Organization
LIV WELLNESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN ANTHONY ROBILIO (OWNER)
(888) 403-6446
Entity
Organization
Contact information
Practice address
4949 S CONGRESS AVE STE E, PALM SPRINGS, FL 33461-4731
(888) 403-6446
Mailing address
4949 S CONGRESS AVE STE E, PALM SPRINGS, FL 33461-4731
(888) 403-6446
Taxonomy
Speciality
Code
Description
License number
State
103TP2701X
Group Psychotherapy Psychologist
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
1018009
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1018009
DEPARTMENT OF CHILDREN AND FAMILIES
FL
Enumeration date
04/19/2018
Last updated
06/11/2019
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